Contraception Then and Now

When it comes to contraception, one thing is for sure: We’ve come a long way! And while the future might have even better things in store, like reversible male birth control, superior condoms, or remote-controlled implants, a look into the past reveals that modern contraceptors have a bevy of fantastic options to choose from. Unlike couples who had to forgo contraception or obtain birth control from the black market, nowadays Americans wishing to prevent or postpone pregnancy can select from a variety of legal, effective, and increasingly accessible family-planning methods.

While the history of birth control is fascinating, today’s contraception is the very best.

Let’s look at some old-fashioned birth-control methods and see how they stack up to their modern-day counterparts.

Linen and Guts vs. Latex and Polyurethane Condoms

Most people think of female condoms as new inventions, but the first condom recorded in history was made out of a goat’s bladder and inserted into the vagina — way back in 3000 BC. Ancient civilizations, from the Romans to the Egyptians to the Japanese, made penile sheaths and caps with a variety of materials, including linen, leather, lubricated silk paper, intestines, and tortoise shells. Linen and intestines remained popular through the Renaissance era.

A condom, with user manual, 1813. Photo: Matthias Kabel

Charles Goodyear might be most famous for tires, but his discoveries in vulcanizing rubber also led to the development of rubber condoms in the mid-1800s. Unfortunately, the Comstock Act of 1873 outlawed the manufacture and sale of contraception, and condoms were driven into a shadow economy. In the 1880s, New Yorkers might have been lucky to find black-market condoms made from surplus animal intestines, which were manufactured by Julius Schmid, a German immigrant who otherwise specialized in sausage casings — before his business was shut down by the New York Society for the Suppression of Vice. Condoms weren’t legal in the United States until the Crane ruling of 1918, just in time for the 1920 invention of latex, a form of rubber that was much stronger and more elastic — and with a shelf life of five years vs. rubber’s three months. By the 1920s, Schmid was once again on top of the condom game, peddling brands like Sheik, Ramses, and Sphinx.

Condoms made out of intestines are still on the market, sold as lambskin or “natural” condoms. However, they are not recommended for STD protection: Just as intestines need to allow nutrients to enter the body from digesting food, so too are viruses able to pass through condoms made from intestines. (Sperm, on the other hand, are thought to be too big.) These days, latex is the gold-standard material for condoms, while polyurethane can be used by people with latex allergies. Condoms constructed with these modern materials protect users from unintended pregnancy as well as many sexually transmitted infections, such as HIV and chlamydia.

Stem Pessaries vs. Copper and Hormonal IUDs

A German stem pessary from the late 1920s. Image: Wellcome Trust

A German stem pessary, late 1920s. Image: Wellcome Trust

In the late 1800s, devices called stem pessaries were inserted into the uterus to prevent conception. They were made of metal or glass, with a stem passing through the cervix and a disk covering the uterine entrance. In the pre-antibiotic era, inserting such a device was accompanied by infection risk — but in those days, childbirth was even more dangerous. These early IUDs were thought to act as irritants, enlisting the immune system to kill sperm.

Nowadays, IUDs release hormones or spermicidal copper ions, and are among the most effective birth-control methods available. In the first year of use, 2 out of 1,000 hormonal IUD users, and 8 out of 1,000 copper IUD users, will become pregnant.

Womb Veils vs. Diaphragms and Cervical Caps

The phrase “womb veil” doesn’t just sound like some Victorian-era euphemism — it actually refers to an 1800s precursor to contemporary diaphragms and cervical caps. According to its inventor, a woman using a womb veil could experience “full enjoyment of the conjugal embrace,” and her “husband would hardly be likely to know that it was being used.” The womb veil was a one-size-fits-all device that was constructed of rubber or “cloth membrane” and retailed for $6. In the Comstock era, they weren’t legal until the 1930s, after legal action initiated by Planned Parenthood founder Margaret Sanger.

Modern diaphragms and cervical caps are made of silicon, and are options for people wishing to prevent pregnancy while avoiding hormonal methods. They are best paired with spermicide, and are much more effective when the male partner uses a condom or practices the pull-out method.

Lysol vs. Emergency Contraception

lysolOver-the-counter products were very popular in the days before contraception enjoyed fully legalized status, although they were marketed using euphemistic language. Lysol, for example, was advertised as an “antiseptic douche,” which could be used after vaginal intercourse to prevent pregnancy. In actuality, douching is not an effective birth-control method; a 1933 study found that Lysol had almost a 50 percent failure rate when it came to preventing pregnancy. Worse, there were many reports of users being burned — even killed — by the harsh chemicals present in Lysol.

A much better option after unprotected vaginal intercourse is emergency contraception, or EC. “Morning-after pills” such as Plan B and Next Choice are available at a pharmacy without a prescription. They are 89 percent effective within three days of unprotected sex, making them a much safer and more effective over-the-counter purchase than Lysol. Other forms of EC, such as a pill called ella or a copper IUD called Paragard, do require a prescription and a visit to a health-care provider. Within five days of unprotected sex, ella is 85 percent effective in preventing pregnancy, while Paragard is 99 percent effective. Additionally, ella and Paragard are more effective in overweight individuals, for whom Plan B and Next Choice might not work as well.

Whether you’re interested in picking up condoms or the morning-after pill, or being fitted for a diaphragm or IUD, Planned Parenthood has all your bases covered. Visit your local Planned Parenthood health center for a birth control consultation to find the perfect method!